Marworth treats soul and addiction

A 29-year-old Nicholson man who escaped from police custody last August after authorities found 630 packets of heroin in his home, could face as much as 17 years in state prison and $255,000 in fines. Ryan Forrest Kiernan, of Lenape Lane, appeared before
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The last few years have seen a tremendous rise in the abuse and addiction of opiates, particularly heroin. The situation has become so bad that Vangarelli terms it a ‘pandemic.’

“About the last three to five years, we’ve probably been treating about 60 percent of opiate addicted patients under the age of 30,” Vangarelli explained.

Kimberly Kabernagel, Addiction Medicine Fellow at Geisinger Marworth, said that before the rise of opiate abuse became so prominent, types of addictions they treated were a much broader mix - which included alcohol and barbiturates.

What has caused the explosion of opiate addiction, Vangarelli said, is because many people start with prescription opiates, acquiring them either for medication, or illegal use. These people become addicted, either through over-medication, or because they abuse the drug. Over time, the addicts change to heroin because it’s less expensive.

“It’s more accessible and cheaper,” Vangarelli said, explaining that the average street price of heroin is about $10 a bag, which contains one-tenth of a gram.

The bags are sold in bundles of 10, Vangarelli said, and it is not unusual for an addict to use a bundle and a half a day.

“I’ve seen some using up to 40 bags a day,” he said.

The reason we’re seeing more young people get treatment at Marworth is because they are staying on their parents’ insurance programs longer, Vangarelli explained.

“A lot of the people we are seeing are young, highly educated, bright college students who come in for treatment,” he said. “These aren’t morally bad people, the illness just wraps around the entire being.”

Not all of Marworth’s patients are so young. The average age of a patient is 48 years, Vangarelli explained. About 60 percent of their patients are men and 40 percent are women.

About 60 percent of the patients at Marworth are being treated for opiate addiction, Vangarelli continued. Of that group, 90 to 95 percent are under the age of 30, with the dominant group intravenous heroin users.

One question that’s been on many people’s minds as the opiate epidemic has worsened is why are so many young people turning to heroin even though they know the risks.

Vangarelli said he spoke to 73 patients at Marworth, asking them that very question.

“Approximately one-third said that their life is so absorbed in multi-tasking via electronics or other sources, that they need the chemical to decompress (chill), in their life,” Vangarelli explained. “It makes them feel good and calm. They don’t know how to relax naturally.”

Physician Assistant Deb Mendelsohn explained that Marworth employs Dialectical Behavior Therapy to help treat opiate addicts in such circumstances, which provides them with an alternative to managing stress.

“It provides them with a skill set that teaches mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness,” Mendelsohn explained.

This is but one of the various approaches Marworth employs in helping its patients deal with their addictions.

Over the years, Vangarelli explained, Marworth has developed techniques to deal with what is causing a person’s addiction, as opposed to the addiction itself.

“It’s co-existing process addiction,” Vangarelli explained. “We identify the problem which enhances a person’s addiction to drugs. It can be things like sex addiction, a manageable eating disorder, or shopping.

Patients at Marworth all receive individualized treatment, depending on what they need, Vangarelli explained.

“If a person was sexually abused, they get treatment for that, as well as for drug addiction,” he said.

“Anybody can stop using drugs for a period of time. We need to fix the hole in the soul,” Vangarelli said.

“When I first came here in 1994, we dealt with just the chemical dependency,” Vangarelli explained. “Trauma was set aside. The idea was just to get them clean and sober. Now know that it is even more important to treat the reason for the patient’s dependency, to give them a resource coping mechanism to use instead of drugs. It’s a very holistic type of treatment. The reason it works so well is because we have such a highly skilled and dedicated staff.”

All who check into Marworth treatment do so voluntarily, although Vangarelli admitted that many do so because of pressure from outside sources.

“We call it a judge, a grudge or a nudge,” Vangarelli said.

However, one thing most emphasized is that the patient must have a real honest desire to be cured of his or her addiction.

“True motivation must come from the individual,” Mendelsohn said. “It has to a volunteer admission. It must come from within or there is very little chance of success.”

Marworth also encourages its patients to obtain as much support as they can from friends and relatives to battle their addictions.

“Being anonymous is the most dangerous thing,” Mendelsohn explained. “Because if you only have to be honest with yourself, it’s easy to lie to yourself.”

“The addict can’t do it alone,” Vangarelli said. “Family support is essential.”

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